EpiPens have become so expensive people are using riskier DIY alternatives

Mark Zaleski/AP Millions of people with severe allergies carry EpiPens to reverse life-threatening allergic reactions. But as the prices of these auto-injectors have soared, more than quintupling since 2004, many emergency medical responders — and some regular families — are turning to manual syringes as a cheaper alternative.

That's raising concern among some doctors and patient advocates, who warn that it's more complicated to get the correct dose and administer it safely with a syringe.

"Anyone using this approach would require extensive medical training to do it effectively and safely, without contamination or accidental intravenous injection," said Dr. James Baker, Jr., the CEO and chief medical officer of Food Allergy Research & Education. The organization's corporate sponsors include Mylan, which manufactures the EpiPen, and Sanofi, which used to sell a competitor.

Amie Vialet De Montbel felt that she didn't have a choice but to try the syringe.

Her 12-year-old son is so allergic to milk that he wears a mask when he goes out in public. Last month, when she filled his prescription for two 2-packs of EpiPens — one to take to camp, and one for home —the cash register rang up a charge of $1,212.

"I was in absolute shock," said Vialet De Montbel, who lives in Troy, Va. "I don't even pay that much for my mortgage." She has health insurance with a $4,000 deductible, so she would have had to pay the whole sum out of pocket. She didn't buy the EpiPens.

Bob Bird/AP At the doctor's office the next day, a nurse told Vialet De Montbel something she had never heard before: For about $20, she could buy a couple of glass ampules of epinephrine and regular syringes from a local pharmacy, and get the syringes filled with the epinephrine at a doctor's office. They would expire in about three months, whereas EpiPens last about a year, but they could save her more than $1,000. She plans to get the syringes soon.

Meanwhile her older son, age 15, is "carrying expired EpiPens because I can't afford to get him [new ones] right now," she said.

EpiPens — spring-loaded syringes filled with epinephrine — are widely carried by people with life-threatening allergies. Over 3.6 million prescriptions for EpiPen kits were written last year, and another half-million for other similar products, according to data provided by IMS Health.

Some states require schools to stock EpiPens. Emergency medical technicians who aren't certified to give regular injections often carry them as well.

Emergency medical providers have been talking about the rising cost of EpiPens for the past few years, said Dr. Peter Taillac, chair of the medical directors council of the National Association of State EMS Officials.